Psychotic episodes in people with bipolar disorder: Recognizing signs, seeking treatment, and helpful advice
Bipolar disorder, a mood disorder characterized by extreme shifts in mood, can sometimes lead to psychosis. This condition, which involves hallucinations, delusions, confusion, disturbed thoughts, incoherent speech, unusual behavior, and a disconnected view of reality, can be challenging to manage but is treatable.
The cause of psychosis in bipolar disorder is multifactorial, involving both biological predispositions and environmental triggers. Brain circuit abnormalities, particularly those related to dopamine and glutamate regulation, play a significant role in the onset of psychosis, especially during manic episodes [1].
Genetic and biological factors also contribute to the risk of psychosis. Bipolar disorder itself is influenced by genetic factors and physical changes in the brain [3]. Environmental factors such as stress, trauma, sleep deprivation, and substance use can exacerbate symptoms [1][5].
Manic episodes, particularly severe ones, are more likely to trigger psychosis, especially in Bipolar I disorder [1][5]. Certain neurological conditions or injuries can also influence the development of bipolar disorder and associated psychosis [5].
Diagnosing bipolar disorder and psychosis requires a thorough evaluation by a doctor. They will ask about the person's symptoms, medical history, and any recent events, as well as about the use of prescription or other drugs [6].
Treatments for bipolar disorder with psychotic features typically combine counseling services and medication. In cases of severe mania, hospitalization may be necessary [7]. Psychosis can happen at different stages of bipolar disorder, but not everyone with bipolar disorder will experience it [4].
Several medications are available for treating psychosis in bipolar disorder, including olanzapine (Zyprexa), risperidone (Risperdal), quetiapine fumarate (Seroquel), asenapine (Saphris), aripiprazole (Abilify), ziprasidone (Geodon), iloperidone (Fanapt), olanzapine/fluoxetine (Symbyax), paliperidone (Invega), quetiapine (Seroquel XR), lurasidone HCl (Latuda), cariprazine (Vraylar), and olanzapine/fluoxetine (Symbyax) for bipolar mania, and quetiapine (Seroquel XR), lurasidone HCl (Latuda), olanzapine/fluoxetine (Symbyax), cariprazine (Vraylar) for bipolar depression [8].
Diagnosing and treating bipolar disorder, especially in children and teens, can be challenging. Friends or loved ones may consider encouraging a person with bipolar disorder to seek help if they are unaware of their symptoms or reluctant to do so [6].
Bipolar disorder and psychosis share some symptoms with schizophrenia, another chronic psychiatric disorder, including the occurrence of psychosis [9]. Side effects of antipsychotic medications can include unwanted and uncontrollable muscle movements, neuroleptic malignant syndrome (a life-threatening condition involving a high fever and sweating, muscle stiffness, and changes in blood pressure), and potential risks during pregnancy [10].
A doctor may prescribe antipsychotics that a person takes regularly, even when they are not experiencing a manic or depressive episode [10]. People who have never been diagnosed with bipolar disorder may receive antidepressants, which can potentially trigger a manic episode if they have underlying features of bipolar disorder [11].
Anyone experiencing severe episodes of depression or mania should seek help from a doctor or mental health professional. Caregivers of someone with bipolar disorder may need to seek help to manage situations, and tips for doing so include learning about bipolar disorder, managing stress, joining a support group, helping the person set goals, setting boundaries and limits, and seeking support to stick with them if needed [12].
If a child or a teen shows signs of psychosis or experiences mood changes that are more severe than usual for their age group, it is important to consult a doctor [6]. With proper diagnosis, treatment, and support, it is possible for individuals with bipolar disorder to live fulfilling lives.
[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3815534/ [2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3377922/ [3] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3377922/ [4] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3815534/ [5] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3377922/ [6] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3377922/ [7] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3815534/ [8] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3815534/ [9] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3377922/ [10] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3815534/ [11] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3377922/ [12] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3377922/
- Bipolar disorder, a type of disease affecting mental health, is characterized by extreme mood shifts and can sometimes lead to psychosis, a disease marked by hallucinations, delusions, and a disconnected view of reality.
- The cause of psychosis in bipolar disorder is multifactorial, involving biological predispositions, such as brain circuit abnormalities related to dopamine and glutamate regulation, as well as environmental triggers like stress and substance use.
- Genetic factors also contribute to the risk of developing bipolar disorder, a condition influenced by physical changes in the brain.
- Certain neurological conditions or injuries can influence the development of bipolar disorder and associated psychosis.
- Diagnosing bipolar disorder and psychosis requires a thorough evaluation by a doctor, involving questions about symptoms, medical history, and recent events, as well as the use of prescription and other drugs.
- Treatments for bipolar disorder with psychotic features typically combine counseling services and medication, with several options available such as olanzapine, risperidone, quetiapine fumarate, and more.
- If a child or a teen shows signs of psychosis or experiences mood changes that are more severe than usual for their age group, it is important to consult a doctor for proper diagnosis and treatment.
- With proper diagnosis, treatment, and support, individuals with bipolar disorder, a health-and-wellness issue, can live fulfilling lives, and caregivers may need to seek help to manage situations, such as learning about bipolar disorder, managing stress, and joining a support group.
